<script type="text/javascript">

$(document).ready(function(){

$("#jenis_laporan").change(function(){

var jenis_laporan=$(this).val();

if(jenis_laporan=='4'){
	$("#div-tgl-bayar").show();
}

});

});

</script>
<?php
$this->breadcrumbs=array(
	'Hist Claims'=>array('index'),
	'Create',
);

$this->menu=array(
	array('label'=>'List HistClaim', 'url'=>array('index')),
	array('label'=>'Manage HistClaim', 'url'=>array('admin')),
);
?>

<h1>Cetak Laporan Klaim</h1>


<div class="form">

    

    
		<div class="row">
		<div class="col-md-4">
			<div class="widget box">
				<div class="widget-header">
					<h4><i class="icon-reorder"></i> Cetak Laporan </h4>
				</div>
				<div class="widget-content">
				
				<?php $form=$this->beginWidget('bootstrap.widgets.TbActiveForm', array(
					'id'=>'ndk-health-form',
					'action'=>Yii::app()->createUrl("histClaim/pdf"),
					// Please note: When you enable ajax validation, make sure the corresponding
					// controller action is handling ajax validation correctly.
					// There is a call to performAjaxValidation() commented in generated controller code.
					// See class documentation of CActiveForm for details on this.
					'enableAjaxValidation'=>false,
					)); ?>		


					<div class="control-group">
					<label class="control-label">Jenis Laporan</label>
					<div class="controls">
					<select id="jenis_laporan" class="form-control" name="jenis_laporan">
					<option value="1">New Claim</option>
					<option value="2">Ditunda</option>
					<option value="3">Re-Claim</option>
					<option value="4">Diterima</option>
					<option value="5">Ditolak</option>
					</select>
					</div>
					</div>


					<div class="control-group">
					<label class="control-label required">
					Up
					<span class="required">*</span>
					</label>
					<div class="controls">
					<input class="form-control" type="text" name="up" maxlength="50">
					<input class="form-control" type="hidden" name="id_hist_claim" maxlength="50" value="<?php echo $model->id; ?>">
					<input class="form-control" type="hidden" name="type_reg_policy" maxlength="50" value="<?php echo $model->type_reg_policy; ?>">
					<input class="form-control" type="hidden" name="reg_policy_id" maxlength="50" value="<?php echo $model->reg_policy_id; ?>">
					</div>
					</div>

					<div class="control-group">
					<label class="control-label required">
					Pejabat Agra
					<span class="required">*</span>
					</label>
					<div class="controls">
					<input class="form-control" type="text" name="pejabat" maxlength="50">
					</div>
					</div>


					<div class="control-group">
					<label class="control-label required">
					Tanggal Cetak
					<span class="required">*</span>
					</label>
					<div class="controls">
					<input class="form-control input-width-small" type="text" value="<?php echo date('d-m-Y'); ?>" name="tgl_cetak" data-mask="99-99-9999">
					</div>
					</div>

					<div class="control-group" id="div-tgl-bayar" style="display:none">
					<br />
					<label class="control-label required">
					Tanggal Pembayaran
					<span class="required">*</span>
					</label>
					<div class="controls">
					<input class="form-control input-width-small" type="text" name="tgl_bayar" data-mask="99-99-9999">
					</div>
					</div>	


					<div class="row">
					<div class="col-md-12">
					  <div class="form-actions">
			        <?php echo TbHtml::submitButton('Cetak',array(
					    'color'=>TbHtml::BUTTON_COLOR_PRIMARY,
					    'size'=>TbHtml::BUTTON_SIZE_LARGE,
					)); ?>
					</div>
					</div>
					</div>

					<?php $this->endWidget(); ?>
				</div>
			</div>
		</div>
		
		<div class="col-md-4">
			<div class="widget box">
				<div class="widget-header">
					<h4><i class="icon-reorder"></i> Cetak Lampiran </h4>
				</div>
				<div class="widget-content">

					<?php $form=$this->beginWidget('bootstrap.widgets.TbActiveForm', array(
					'id'=>'ndk-health-form',
					'action'=>Yii::app()->createUrl("histClaim/excell"),
					// Please note: When you enable ajax validation, make sure the corresponding
					// controller action is handling ajax validation correctly.
					// There is a call to performAjaxValidation() commented in generated controller code.
					// See class documentation of CActiveForm for details on this.
					'enableAjaxValidation'=>false,
					)); ?>
			
					<div class="control-group">
					<label class="control-label">Status Peserta Klaim</label>
					<div class="controls">
					<select id="jenis_laporan" class="form-control" name="jenis_laporan">
					<option value="1">New Claim</option>
					<option value="2">Ditunda</option>
					<option value="3">Re-Claim</option>
					<option value="4">Diterima</option>
					<option value="5">Ditolak</option>
					</select>
					</div>
					</div>
					
					<input class="form-control" type="hidden" name="id_hist_claim" maxlength="50" value="<?php echo $model->id; ?>">
					<input class="form-control" type="hidden" name="type_reg_policy" maxlength="50" value="<?php echo $model->type_reg_policy; ?>">
					<input class="form-control" type="hidden" name="reg_policy_id" maxlength="50" value="<?php echo $model->reg_policy_id; ?>">

					<div class="row">
					<div class="col-md-12">
					  <div class="form-actions">
			        <?php echo TbHtml::submitButton('Cetak',array(
					    'color'=>TbHtml::BUTTON_COLOR_PRIMARY,
					    'size'=>TbHtml::BUTTON_SIZE_LARGE,
					)); ?>
					</div>
					</div>
					</div>

					<?php $this->endWidget(); ?>


				
	</div>
			</div>
		</div>
		

		
	</div>
	
	
	
	
	
	
    

</div><!-- form -->